Study On The Countermeasures Of Chinese Medicine Participating In AIDS Prevention And Control

BackgroundThe prevention and control of AIDS is one of the extremely challenging public health tasks around the globe. Therefore, it is inevitable that mobilizing all the resources we currently have and utilizing all the achievements we have made to fight AIDS. From this perspective, traditional medicine like Traditional Chinese Medicine (TCM), as well as modern medicine like Western Medicine (WM), has made great progress during the past several decades. Currently, the treatment of HAART, a kind of antiviral therapy, is considered to be the main-stream way to treat AIDS in the medical field. This treatment, however, may cause a variety of side effects such as abnormal liver function, sicchasia, diarrhea, headache, and fatigue. Fortunately, plenty of researches have testified that TCM, as one of the typical traditional medicine, has played a special role in alleviating the adverse effects of antiviral therapy. In the meanwhile, after experiencing a lot of researches and practices in the past several decades, TCM has formed a set of special AIDS treatment theories and assessment methods.Chinese government always pays attention to the function of TCM in the prevention and treatment of AIDS, and has enacted series of laws, regulations, and polies to encourage TCM to participate in the prevention and treatment of AIDS. It has been more than 10 years since a pilot work called using TCM to treat AIDS was implemented in 2004. And the number of pilot provinces in China has expanded from 9 to 19 since 2004. Even though State Administration of Traditional Chinese Medicine has carried out the pilot project in 19 provinces, the work of utilizing TCM to treat AIDS still does not establish an intact and independent system due to different reasons. As a result, the majority of TCM methods on treating AIDS are merely limited to the pilot phrase. Furthermore, TCM and WM cannot work together, but just do their own job separately in the prevention and treatment of AIDS.ObjectiveWe reckon that the work of TCM participating in the prevention and treatment of AIDS has a lot of obstacles including subjective and objective factors. Currently, we lack systematic researches regarding the countermeasures on TCM participating in the prevention and treatment of AIDS.This research generally aims to analyze the strength, weakness, opportunity, and threat of TCM in the prevention and treatment of AIDS and provide policy suggestions that promote TCM to act better in the prevention and treatment of AIDS on the basis of describing the status quo of global traditional medicine, the epidemic trend of AIDS, the current situation of the prevention and treatment of AIDS in China, the pilot status of TCM participating the prevention and treatment of AIDS, the cooperation between TCM and WM in the prevention and treatment of AIDS, as well as the research practices of using TCM to treat AIDS, etc. The specific objectives include:1) establishing a framework of influencing factors that affect the prevention and treatment of AIDS; 2) analyzing the international context of TCM participating in the prevention and treatment of AIDS, describing laws, regulations and policies of TCM participating in the prevention and treatment of AIDS in China, and exploring the effects and problems of policy implementation; 3) analyzing achievements and challenges of using TCM to prevent and treat AIDS and providing specific advices of improving effects of using TCM to treat AIDS; 4) summarizing main achievements and problems of the pilot work of using TCM to treat AIDS as well as analyzing its cause; 5) summing up the status quo and main problems of the collaboration between TCM and WM in the prevention and treatment of AIDS in terms of important policy-making, scientific researches, and clinical practices; and 6) providing policy suggestions that enhance TCM to participate in the prevention and treatment of serious infectious diseases such as AIDS.MethodsDescriptive analysis, combining with synthetic evaluation, Delphi method, complete investigation, sample survey, SWOT analysis, and stakeholder analysis, was used to process different types of data respectively.Results1) The value of Cr is 0.88, which means the Delphi method used by this research is convincing. Eventually, this research defines determinants of the prevention and treatment of AIDS as 6 first-class indicators and 18 second-class indicators. These first-class indicators contain treatment effects, international environment, domestic environment, consequences of using TCM to treat AIDS in the pilot work, the status quo of combining TCM and WM to fight AIDS, and social satisfaction, etc.2) Treatment itself, treatment standard, treatment publicity, treatment accreditation, the specificity of TCM diagnosis and treatment, and antiviral treatment effect, are coded by A01, A02, A03, A04, A05, and A06 respectively, and are also defined as second-grade indicators in the framework of determinants in this research. This also implies that other indications such as treatment standard are as the same important as the indicator of treatment itself.3) According to the norm of random controlled trial (RCT), a part of pilot researches concerning utilizing TCM to treat AIDS have positive effects. However, because of the poor quality of methodology and the great variance of TCM treatment approaches in a vast majority of experimental researches, it is necessary to design better RCTs to test the potential strength of the curative effect and safety of TCM prescription.4) International society pays inadequate attention to traditional medicine like TCM involving in the prevention and treatment of AIDS.5) Chinese government has made relevant policies to support and encourage TCM to play a good role in the treatment of AIDS in order to let this work have laws and rules to follow. Nevertheless, direct high-level regulations and policies related to this issue are very few and specific objectives regarding TCM participating in the prevention and treatment of AIDS are unclear. In addition, from the perspective of AIDS diagnosis and treatment, TCM and WM separate from each other, which means they cannot collaborate into a whole entity. Furthermore, for the sake of facilitating TCM to involve in AIDS treatment, we lack supporting policies like examination and approval systems of using TCM to treat AIDS, health insurance systems and long-term staff training systems, etc.6) In terms of pilot scale, the pilot place of utilizing TCM to treat AIDS has increased from 5 provinces to 19 provinces since 2004, and the quantity of pilot institution has also gone up from 25 to 179 since 2012, and healthcare practitioners involved in the pilot work have risen from 296 people to 844 people since 2012. From this point of view, the pilot work of TCM has preliminarily established a well-organized system which contains a lot of relatively stable healthcare practitioners. However, in general, the scale of healthcare staff is inadequate and tough enough to sustain our current jobs. In addition, even though the pilot work has implemented for nearly 10 years, the variety of TCM preparation still cannot satisfy the current clinical demand due to its slow growth rate. As well, although the total financial input of treating AIDS is always rising, its growth rate among different parts is unbalanced, mainly focusing on Chinese medicines, which leads to too little input on personnel expenses.7) Generally speaking, based on current materials, there is some type of collaboration between TCM and WM in the substantial policy-making, but the cooperating intensity is pretty weak. The amount of researches on using TCM to prevent and treat AIDS is relatively rare compared to the researches of common diseases. Moreover, in the research of TCM treating AIDS, there are also various problems, such as small-scale funding, short-term research, poor research ability, as well as lack of the cooperation between TCM and WM.In the clinical practice, antiviral therapy is the most popular method of treating AIDS in WM compared with TCM and public health; combined treatment of TCM and WM is the most favorite approach in the TCM and public health practitioners compared to WM staff; western medicines is the most popular way to use in public health workers by contrast with TCM professionals. The main disputes on the treatment of AIDS among these three groups do not lie in whether or not Chinese medicine is effective, but in whether or not single antiviral therapy in WM is the best practice.8) In terms of the participation and recognition with respect to TCM involving in the prevention and treatment of AIDS, approximately 90% inhabitants have ever seen the TCM doctors or have had Chinese medicines. This indicates that the recognition of the utilization of TCM and Chinese medicines, as well as TCM participation in the prevention and treatment of AIDS is ubiquitous in sample areas. Chinese patent drug is the most popular Chinese medicines for the respondents.RecommendationIn order to promote TCM to play a more significant role in the treatment of AIDS, the key step is to improve the recognition level on the curative effect of TCM in the whole society, especially to enhance international society to permit the standard of using TCM to treat AIDS. The kernel for China is to deal with the issue of curative effect such as setting up a set of reasonable and permitted clinical standard, producing high-level clinical trials, and summarizing current research outputs. Some important jobs include:increasing the involvement power of TCM on the considerable policy-making of the prevention and treatment of AIDS, shifting the utilization of TCM on treating AIDS from the experimental phrase to the complete implementation in China, resolving problems of technical barriers to ensure the cooperation between the Clinical Diagnosis and Treatment Guideline of AIDS and the Pilot Clinical Technical Scheme on Using TCM to Treat AIDS for the sake of shaping a comprehensive scheme of AIDS diagnosis and treatment which containing Chinese medicines and western medicines.